, Volume 2, Issue 1, pp 82-92

Meeting them where they are: Using the Internet to deliver behavioral medicine interventions for pain

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Abstract

Pharmacological and interventional pain medicine treatments are emphasized in the routine treatment of chronic pain despite strong evidence for the efficacy and safety of behavioral approaches. Most medical professionals have not incorporated behavioral pain treatments into their practices. Internet-based interventions have the potential to increase clinical use of these treatments. We discuss the strengths and weaknesses of current Internet-based behavioral pain management interventions, focusing on three broad intervention categories: therapist-guided interventions, unguided (automated) interventions, and pain-relevant applications for mobile platforms. Examples of each category are discussed, revealing a high degree of variation in approaches, user interfaces, and components as well as variability in the degree to which these interventions have been subjected to empirical testing. Finally, we highlight key issues for research and clinical implementation, with the goal of advancing this field so that it can meet its potential to increase access to evidence-based behavioral medicine treatments for chronic pain.

Implications

Practice: Internet-based behavioral medicine interventions for managing chronic pain have the potential to increase access to behavioral pain treatments, which have been underused in routine treatment of chronic pain despite strong evidence for their efficacy and safety.
Policy: Although promising, funding and policy attention to research and systemic barriers related to the design, implementation, and evaluation of Internet-based behavioral pain interventions must be addressed if these approaches are to play a significant role in increasing access to the evidence-based treatments on which they are based.
Research: There is a pressing need for rigorous and methodologically sophisticated clinical trials that compare the efficacy of Internet-based behavioral pain interventions to other credible interventions; research to guide intervention development and clinical implementation of these interventions is also needed.